Failures in the treatment of eyes can result in a successful claim for compensation.

Common problems relate to correcting long or short-sightedness by laser surgery (please see below), trauma to the eyes and the treatment of glaucoma.

See also the information sheet on Diabetic Retinopathy.

Case reports

Hospital negligence led to loss of sight in one eye

Our client went to a private ENT specialist who told her that there was a hole in the wall between the 2 nostrils and bleeding was occurring around this.

An operation took place to repair this but the lack of after care and monitoring failed to spot the bleed into the eye socket which led to irreversible damage to the optic nerve.

She was blinded in her left eye.  She obtained over £40,000 in compensation for her loss of sight in one eye. 

If you would like to speak to the solicitor who settled this case please contact Claire Horton on freephone 0808 144 0957or at our Manchester office telephone number on 0161 834 1251 or email: hort@johnpickering.co.uk

LASIK EYE SURGERY

Definition

LASIK, an acronym for Laser-Assisted in Situ Keratomileusis, is a form of refractive laser eye surgery procedure performed by ophthalmologists intended for correcting  long and/or short-sightedness.

Many patients choose LASIK as an alternative to wearing corrective glasses or contact lenses. While LASIK has the ability to provide acute vision, there is no benchmark to quantify the quality of the image a patient sees.

Procedure

• Preoperative

Patients wearing soft contact lenses typically are instructed to stop wearing them approximately 7 to 10 days before surgery. One industry body recommends that patients wearing hard contact lenses should stop wearing them for a minimum of six weeks plus another six weeks for every three years the hard contacts had been worn. Before the surgery, the patient's corneas are examined with a pachymeter to determine their thickness, and with a topographer to measure their surface contour. Using low-power lasers, a topographer creates a topographic map of the cornea. This process also detects astigmatism and other irregularities in the shape of the cornea. Using this information, the surgeon calculates the amount and locations of corneal tissue to be removed during the operation. The patient typically is prescribed an antibiotic to start taking beforehand, to minimize the risk of infection after the procedure.

• Operation

The operation is performed with the patient awake and mobile; however, the patient typically is given a mild sedative (such as Valium) and anesthetic eye drops.

Lasik is performed in two steps. The initial step is to create a flap of corneal tissue. This process is achieved with a mechanical microkeratome using a metal blade, or a femtosecond laser microkeratome (procedure known as IntraLASIK) that creates a series of tiny closely arranged bubbles within the cornea. A hinge is left at one end of this flap. The flap is folded back, revealing the stroma, the middle section of the cornea. The process of lifting and folding back the flap can be uncomfortable.

The second step of the procedure is to use an excimer laser (193 nm) to remodel the corneal stroma. The laser vaporizes tissue in a finely controlled manner without damaging adjacent stroma by releasing the molecular bonds that hold the cells together. No burning with heat or actual cutting is required to ablate the tissue. The layers of tissue removed are tens of micrometers thick.

During the second step, the patient's vision will become very blurry once the flap is lifted. He/she will be able to see only white light surrounding the orange light of the laser. This can be disorienting.

Currently manufactured excimer lasers use a computer system that tracks the patient's eye position up to 4,000 times per second, redirecting laser pulses for precise placement. After the laser has reshaped the cornea, the Lasik flap is repositioned over the treatment area by the surgeon. The flap remains in position by natural adhesion until healing is completed.

Performing the laser ablation in the deeper corneal stroma typically provides for more rapid visual recovery and less pain.

• Postoperative

Patients are usually given a course of antibiotic and anti-inflammatory eye drops. These are discontinued in the weeks following surgery. Patients are also given a darkened pair of goggles to protect their eyes from bright lights and protective shields

Pros

The reported figures for safety and efficacy are open to interpretation. In 2003, the Medical Defence Union (MDU), the largest insurer for doctors in the United Kingdom, reported a 166% increase in claims involving laser eye surgery; however, the MDU averred that these claims resulted primarily from patients' “unrealistic expectations” of LASIK rather than “faulty surgery”. A 2003 study reported in the medical journal Ophthalmology found that nearly 18% of treated patients and 12% of treated eyes needed retreatment. The authors concluded that “higher initial corrections, astigmatism, and older age are risk factors for LASIK retreatment.”

In 2004, the British National Health Service's National Institute for Health and Clinical Excellence (NICE) considered a systematic review of four randomized controlled trials before issuing guidance for the use of LASIK within the NHS. Regarding the procedure's efficacy, NICE reported, "Current evidence on LASIK for the treatment of refractive errors suggests that it is effective in selected patients with mild or moderate short-sightedness" but that "evidence is weaker for its effectiveness in severe short-sightedness and long-sightedness." Regarding the procedure's safety, NICE reported that "there are concerns about the procedure's safety in the long term and current evidence does not appear adequate to support its use within the NHS without special arrangements for consent and for audit or research." Leading refractive surgeons in the United Kingdom and United States, including at least one author of a study cited in the report, believe NICE relied on information that is severely dated and weakly researched.

Various surveys have been performed to determine patient satisfaction with LASIK. These surveys have found most patients to be satisfied, with anywhere from 92-98% of respondents describing themselves as satisfied. Those who are unsatisfied tend to be those who have had some of the above-described complications.

Cons

Accounts of problems patients of LASIK surgery have had are documented at www.lasikeyesurgerywebsite.com

Notes

John Pickering and Partners LLP

About Us

Our clients are people who have suffered injury as a result of a medical accident in the UK.  We are clinical and medical negligence solicitors.  We handle negligence claims against hospitals, GP’s and other medical practitioners for clients across the UK. 

We try to obtain maximum amounts of compensation. 

We are committed to providing public funding (previously known as Legal Aid) and have a franchise from the Community Legal Services Commission.  This means that they have looked at the firm carefully and approved of the way we work.  They consider that we are medical negligence claims specialists.  They trust us to handle medical accident claims properly. 

If you are not eligible for public funding, we can offer a Conditional Fee Agreement, also known as a ‘no win, no fee’ agreement with insurance.  We shall check the best method of funding your claim. 

All 3 of our offices (Liverpool, Manchester and Halifax) are accredited by the Association of Personal Injury Lawyers. 

Claire Horton is an experienced clinical negligence solicitor who is based in our Manchester office.  She continues to practice as an independent funding ajudicator for the Legal Services Commission and acts on a pro-bono basis for the AvMA helpline.

For further advice on medical negligence in Liverpool please also contact Rachel Donovan and for Halifax contact Ruth Davies, who are both experienced in the field of clinical negligence.

We provide free initial advice to people seeking information about a potential clinical negligence claim. 

If you need advice about a clinical negligence claim, contact us now for information about making a claim for compensation.